Disulfiram is a pharmaceutical used in treating alcohol dependence. The medication is known for producing unpleasant physical symptoms when alcohol is consumed. Learn more about how this drug works, the potential side effects of its use, and why it is an effective treatment.
Background & History
The history of disulfiram dates back to the 1940s, when a Danish professor of pharmacology accidentally discovered the adverse reaction of disulfiram to alcohol. Although the professor suggested using disulfiram as a form of treatment for those suffering from alcoholism, the idea failed to gain traction until the early 1950s.
In 1951, Disulfiram was approved as a treatment option for alcohol abuse in the United States. During the following decades, negative associations with disulfiram became more and more common as doctors continued to prescribe dangerously high dosages of the drug. Even as more appropriate dosages were determined, exaggerations of disulfiram’s unpleasant side effects also damaged its credibility as a safe medication.
Today, disulfiram is recognized as both a safe and effective way to discourage alcohol abuse. Contrary to popular belief, disulfiram is only prescribed to patients who fully consent to the medication’s unpleasant reaction to alcohol.
Treatment for Alcohol Abuse
When administered as treatment for alcohol abuse, disulfiram serves the role of a deterrent by having no effect on the body unless alcohol is consumed. Therefore, this medication is used in conjunction with an inpatient or outpatient treatment program and individual and group therapy.
Mechanism of Action
The mechanism of action performed by disulfiram, or how the medication actually creates feelings of sickness when taken with alcohol, involves altering a chemical process in the body. Disulfiram prevents an enzyme in the liver known as aldehyde dehydrogenase from breaking down the alcohol properly. Without the presence of alcohol in the body, the medication does not affect the way your body function unless you experience some of the common side effects.
Reaction with Alcohol
If alcohol is consumed while taking disulfiram, you will experience symptoms of sickness such as:
- Nausea & vomiting
- Accelerated heartbeat
- Chest pain
- Shortness of breath
- Blurry vision
- Excessive sweating
Disulfiram toxicity is rare, but can occur when large amounts of alcohol are ingested while taking the medication. Less common causes of disulfiram toxicity include an overdose of disulfiram or an adverse reaction to the medication. Disulfiram toxicity can lead to long-term liver issues and is sometimes fatal, so you should seek out immediate medical assistance if you experience the following symptoms:
- Loss of vision
- Intense eye pain
- Complete loss of appetite
- Dark urine
Duration of Treatment
Disulfiram should be taken daily until you have demonstrated significant progress in other programs involved in the treatment of alcohol abuse. Once it is determined that you no longer need an active deterrent for relapse, you may stop taking disulfiram. It may take anywhere between a few months and a few years to reach this point.
The recommended dosage for disulfiram varies within an approved range of 125 to 500 mg, depending on the individual case of alcohol abuse. Therefore, it’s important to talk to your doctor about the correct dosage before taking disulfiram as part of your treatment. The most common daily adult dosage is as follows:
Oral tablets: 250 mg a day
Patients may be prescribed a higher dosage of disulfiram in the initial treatment phase, usually around 500 mg a day. Sometimes, a higher dosage can induce drowsiness. In the event of excessive drowsiness, prescribers will sometimes recommend a lower dose or that the patient takes the medication before going to bed.
The suggested method for taking disulfiram is crushing the tablets and combining the odorless, tasteless powder with a glass of water.
Disulfiram can prompt a few side effects, even when alcohol is not ingested. Some of these side effects may include:
- Skin rash
- Metallic taste in the mouth
Typically, these side effects are not severe and do not require immediate medical attention. However, if you feel that the side effects are particularly intense or abnormal, seek immediate assistance from medical professionals.
Disulfiram Drug Interactions
Due to the possibility of disulfiram interacting with other prescribed medications, you should take a few precautions before incorporating disulfiram into your alcohol treatment regimen. It’s important to check with your doctor about possible interactions with any other prescribed medication you are taking.
There are hundreds of medications known to potentially have an adverse reaction to disulfiram, ranging from mild to severe effects. A handful of medications with interactions that are commonly asked about include: